Simpleback 34

app/controllers/api/v4/patient_scores_controller.rb

@@ -0,0 +1,40 @@
+class Api::V4::PatientScoresController < Api::V4::SyncController
+  def sync_to_user
+    __sync_to_user__("patient_scores")
+  end
+
+  def current_facility_records
+    @current_facility_records ||=
+      PatientScore
+        .for_sync
+        .where(patient: current_facility.prioritized_patients.select(:id))
+        .order(:updated_at, :id)
+        .limit(limit)
+        .offset((current_page - 1) * limit)
+        .to_a
+  end
+
+  def other_facility_records
+    []
+  end
+
+  private
+
+  def transform_to_response(patient_score)
+    Api::V4::PatientScoreTransformer.to_response(patient_score)
+  end
+
+  def current_page
+    page = process_token[:next_page].to_i
+    page < 1 ? 1 : page
+  end
+
+  def response_process_token
+    {
+      current_facility_id: current_facility.id,
+      next_page: current_facility_records.empty? ? 1 : current_page + 1,
+      resync_token: resync_token,
+      sync_region_id: current_sync_region.id
+    }
+  end
+end

app/models/patient_score.rb

@@ -0,0 +1,13 @@
+class PatientScore < ApplicationRecord
+  include Mergeable
+  include Discard::Model
+
+  belongs_to :patient, optional: true
+
+  validates :device_created_at, presence: true
+  validates :device_updated_at, presence: true
+  validates :score_type, presence: true
+  validates :score_value, presence: true, numericality: true
+
+  scope :for_sync, -> { with_discarded }
+end

app/schema/api/v4/models.rb

@@ -117,6 +117,20 @@ def patient_attribute
        required: %w[id patient_id height weight created_at updated_at]}
     end
 
+    def patient_score
+      {type: :object,
+       properties: {
+         id: {"$ref" => "#/definitions/uuid"},
+         patient_id: {"$ref" => "#/definitions/uuid"},
+         score_type: {"$ref" => "#/definitions/non_empty_string"},
+         score_value: {type: :number},
+         deleted_at: {"$ref" => "#/definitions/nullable_timestamp"},
+         created_at: {"$ref" => "#/definitions/timestamp"},
+         updated_at: {"$ref" => "#/definitions/timestamp"}
+       },
+       required: %w[id patient_id score_type score_value created_at updated_at]}
+    end
+
     def patient_phone_number
       {
         type: :object,
@@ -458,6 +472,8 @@ def definitions
         patient: patient,
         patient_attribute: patient_attribute,
         patient_attributes: Api::CommonDefinitions.array_of("patient_attribute"),
+        patient_score: patient_score,
+        patient_scores: Api::CommonDefinitions.array_of("patient_score"),
         patient_business_identifier: Api::V3::Models.patient_business_identifier,
         patient_business_identifiers: Api::CommonDefinitions.array_of("patient_business_identifier"),
         phone_number: Api::V3::Models.phone_number,

app/transformers/api/v4/patient_score_transformer.rb

@@ -0,0 +1,19 @@
+class Api::V4::PatientScoreTransformer < Api::V4::Transformer
+  class << self
+    def to_response(payload)
+      super(payload)
+        .merge({
+          "score_type" => payload["score_type"],
+          "score_value" => payload["score_value"].to_f
+        })
+    end
+
+    def from_request(payload)
+      super(payload)
+        .merge({
+          "score_type" => payload["score_type"],
+          "score_value" => payload["score_value"].to_f
+        })
+    end
+  end
+end

config/routes.rb

@@ -71,6 +71,10 @@
       get "sync", to: "cvd_risks#sync_to_user"
       post "sync", to: "cvd_risks#sync_from_user"
     end
+
+    scope :patient_scores do
+      get "sync", to: "patient_scores#sync_to_user"
+    end
   end
 
   namespace :webview do

db/data/20260414103256_spread_patient_scores_updated_at.rb

@@ -0,0 +1,55 @@
+# frozen_string_literal: true
+
+class SpreadPatientScoresUpdatedAt < ActiveRecord::Migration[6.1]
+  def up
+    # Find the clustered timestamp that's causing sync pagination issues
+    # This happens when bulk inserts share the same updated_at
+    clustered_timestamps = PatientScore.group(:updated_at)
+      .having("count(*) > 1000")
+      .count
+      .keys
+
+    return if clustered_timestamps.empty?
+
+    clustered_timestamps.each do |clustered_timestamp|
+      Rails.logger.info "Spreading updated_at for PatientScores with timestamp: #{clustered_timestamp}"
+
+      # First, check if device_updated_at is well-distributed
+      device_updated_distribution = PatientScore
+        .where(updated_at: clustered_timestamp)
+        .group(:device_updated_at)
+        .count
+        .sort_by { |_, n| -n }
+        .first(5)
+
+      max_device_cluster = device_updated_distribution.first&.last || 0
+
+      if max_device_cluster < 1000
+        # device_updated_at is well-distributed, use it
+        Rails.logger.info "Using device_updated_at (max cluster: #{max_device_cluster})"
+        PatientScore
+          .where(updated_at: clustered_timestamp)
+          .update_all("updated_at = device_updated_at")
+      else
+        # device_updated_at is also clustered, spread by id with millisecond offsets
+        Rails.logger.info "Spreading by id with millisecond offsets (device_updated_at max cluster: #{max_device_cluster})"
+        ActiveRecord::Base.connection.execute(<<-SQL.squish)
+          UPDATE patient_scores ps
+          SET updated_at = '#{clustered_timestamp}'::timestamp
+                         + (sub.row_num * interval '1 millisecond')
+          FROM (
+            SELECT id, row_number() OVER (ORDER BY id) AS row_num
+            FROM patient_scores
+            WHERE updated_at = '#{clustered_timestamp}'
+          ) sub
+          WHERE ps.id = sub.id
+        SQL
+      end
+    end
+  end
+
+  def down
+    # This migration cannot be reversed as we don't track original values
+    raise ActiveRecord::IrreversibleMigration
+  end
+end

db/migrate/20260209112204_create_patient_scores.rb

@@ -0,0 +1,24 @@
+class CreatePatientScores < ActiveRecord::Migration[6.1]
+  def change
+    unless table_exists?(:patient_scores)
+      create_table :patient_scores, id: :uuid do |t|
+        t.references :patient, null: false, foreign_key: true, type: :uuid
+        t.string :score_type, null: false, limit: 100
+        t.decimal :score_value, precision: 5, scale: 2, null: false
+        t.datetime :device_created_at, null: false
+        t.datetime :device_updated_at, null: false
+        t.datetime :deleted_at
+
+        t.timestamps
+      end
+    end
+
+    unless index_exists?(:patient_scores, [:patient_id, :score_type])
+      add_index :patient_scores, [:patient_id, :score_type]
+    end
+
+    unless index_exists?(:patient_scores, :updated_at)
+      add_index :patient_scores, :updated_at
+    end
+  end
+end

db/structure.sql

@@ -748,9 +748,7 @@ CREATE TABLE IF NOT EXISTS simple_reporting.reporting_patient_prescriptions (
     hypertension_drug_changed boolean,
     diabetes_drug_changed boolean,
     other_drug_changed boolean,
-    prescribed_statins boolean,
-    latest_cvd_risk_score_lower_range integer,
-    latest_cvd_risk_score_upper_range integer
+    prescribed_statins boolean
     )
     PARTITION BY LIST (month_date);
 
@@ -865,10 +863,7 @@ CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_tabl
             ) elem
             WHERE elem->>'drug_name' ILIKE '%statin%'
         )
-        ) AS prescribed_statins,
-
-        cvd.latest_cvd_risk_score_lower_range,
-        cvd.latest_cvd_risk_score_upper_range
+        ) AS prescribed_statins
 
     FROM simple_reporting.reporting_patient_states rps
     LEFT JOIN reporting_facilities assigned_facility ON rps.assigned_facility_id = assigned_facility.facility_id
@@ -945,27 +940,6 @@ CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_tabl
             )
         )
     ) prev ON TRUE
-
-    LEFT JOIN LATERAL (
-        SELECT
-        split_part(cr.risk_score,'-',1)::int AS latest_cvd_risk_score_lower_range,
-
-        COALESCE(
-            NULLIF(split_part(cr.risk_score,'-',2),''),
-            split_part(cr.risk_score,'-',1)
-        )::int AS latest_cvd_risk_score_upper_range
-
-        FROM cvd_risks cr
-        WHERE cr.patient_id = rps.patient_id
-        AND cr.deleted_at IS NULL
-        AND date_trunc('month',
-                timezone(current_setting('TIMEZONE'),
-                timezone('UTC', cr.device_updated_at))
-            ) < (rps.month_date + interval '1 month')
-
-        ORDER BY cr.device_updated_at DESC
-        LIMIT 1
-    ) cvd ON TRUE
     WHERE rps.month_date = $1
     AND rps.htn_care_state <> 'dead';
     END;
@@ -2709,6 +2683,23 @@ CREATE TABLE public.patient_phone_numbers (
 );
 
 
+--
+-- Name: patient_scores; Type: TABLE; Schema: public; Owner: -
+--
+
+CREATE TABLE public.patient_scores (
+    id uuid NOT NULL,
+    patient_id uuid NOT NULL,
+    score_type character varying(100) NOT NULL,
+    score_value numeric(5,2) NOT NULL,
+    device_created_at timestamp without time zone NOT NULL,
+    device_updated_at timestamp without time zone NOT NULL,
+    deleted_at timestamp without time zone,
+    created_at timestamp(6) without time zone NOT NULL,
+    updated_at timestamp(6) without time zone NOT NULL
+);
+
+
 --
 -- Name: prescription_drugs; Type: TABLE; Schema: public; Owner: -
 --
@@ -7424,6 +7415,14 @@ ALTER TABLE ONLY public.patient_phone_numbers
     ADD CONSTRAINT patient_phone_numbers_pkey PRIMARY KEY (id);
 
 
+--
+-- Name: patient_scores patient_scores_pkey; Type: CONSTRAINT; Schema: public; Owner: -
+--
+
+ALTER TABLE ONLY public.patient_scores
+    ADD CONSTRAINT patient_scores_pkey PRIMARY KEY (id);
+
+
 --
 -- Name: patients patients_pkey; Type: CONSTRAINT; Schema: public; Owner: -
 --
@@ -8527,6 +8526,20 @@ CREATE INDEX index_patient_phone_numbers_on_dnd_status ON public.patient_phone_n
 CREATE INDEX index_patient_phone_numbers_on_patient_id ON public.patient_phone_numbers USING btree (patient_id);
 
 
+--
+-- Name: index_patient_scores_on_patient_id_and_score_type; Type: INDEX; Schema: public; Owner: -
+--
+
+CREATE INDEX index_patient_scores_on_patient_id_and_score_type ON public.patient_scores USING btree (patient_id, score_type);
+
+
+--
+-- Name: index_patient_scores_on_updated_at; Type: INDEX; Schema: public; Owner: -
+--
+
+CREATE INDEX index_patient_scores_on_updated_at ON public.patient_scores USING btree (updated_at);
+
+
 --
 -- Name: index_patient_registrations_per_day_per_facilities; Type: INDEX; Schema: public; Owner: -
 --
@@ -9109,24 +9122,6 @@ CREATE INDEX patient_prescriptions_assigned_organization_region_id ON ONLY simpl
 
 CREATE INDEX index_patient_prescriptions_patient_id ON ONLY simple_reporting.reporting_patient_prescriptions USING btree (patient_id);
 
---
--- Name: idx_rpp_month_patient; Type: INDEX; Schema: simple_reporting; Owner: -
---
-
-CREATE INDEX idx_rpp_month_patient ON simple_reporting.reporting_patient_prescriptions (month_date, patient_id);
-
---
--- Name: idx_rpp_latest_cvd_score_lower_range; Type: INDEX; Schema: simple_reporting; Owner: -
---
-
-CREATE INDEX idx_rpp_latest_cvd_score_lower_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_lower_range);
-
---
--- Name: idx_rpp_latest_cvd_score_upper_range; Type: INDEX; Schema: simple_reporting; Owner: -
---
-
-CREATE INDEX idx_rpp_latest_cvd_score_upper_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_upper_range);
-
 --
 -- Name: index_fs_block; Type: INDEX; Schema: simple_reporting; Owner: -
 --
@@ -9165,6 +9160,14 @@ ALTER TABLE ONLY public.patient_phone_numbers
     ADD CONSTRAINT fk_rails_0145dd0b05 FOREIGN KEY (patient_id) REFERENCES public.patients(id);
 
 
+--
+-- Name: patient_scores fk_rails_0209112204; Type: FK CONSTRAINT; Schema: public; Owner: -
+--
+
+ALTER TABLE ONLY public.patient_scores
+    ADD CONSTRAINT fk_rails_0209112204 FOREIGN KEY (patient_id) REFERENCES public.patients(id);
+
+
 --
 -- Name: facility_groups fk_rails_0ba9e6af98; Type: FK CONSTRAINT; Schema: public; Owner: -
 --
@@ -9509,6 +9512,14 @@ ALTER TABLE ONLY public.dr_rai_targets
     ADD CONSTRAINT fk_rails_f0398a9ae0 FOREIGN KEY (dr_rai_indicators_id) REFERENCES public.dr_rai_indicators(id);
 
 
+--
+-- Name: patient_attributes fk_rails_fc46ae3757; Type: FK CONSTRAINT; Schema: public; Owner: -
+--
+
+ALTER TABLE ONLY public.patient_attributes
+    ADD CONSTRAINT fk_rails_fc46ae3757 FOREIGN KEY (patient_id) REFERENCES public.patients(id);
+
+
 --
 -- PostgreSQL database dump complete
 --
@@ -9713,6 +9724,7 @@ INSERT INTO "schema_migrations" (version) VALUES
 ('20260127150000'),
 ('20260128094448'),
 ('20260205110957'),
+('20260209112204'),
 ('20260212195326'),
 ('20260224063659'),
 ('20260316093605'),